Acute myeloid leukemia after breast cancer: a population-based comparison with hematological malignancies and other cancers

Background: Clinical trials frequently report acute myeloidleukemia (AML) as a complication of adjuvant chemotherapy forbreast cancer (BC). Patients and methods: This retrospective population-based studyinvestigated AML risk after a prior BC diagnosis and comparedthe results with women after a prior diagnosis of hematologicalmalignancies (HM), other cancers combined (OCC), and the age-matchedAustralian female population. Results: Women with a prior BC diagnosis had 2.56 times therisk of developing AML compared with the Australian female population(P < 0.001). AML risk was also elevated after prior HM andOCC diagnoses (4.73, P < 0.001, and 1.70, P < 0.001, respectively).Although the incidence of AML rose sharply with age in all cohorts,the age-specific relative risk was highest in the 30- to 49-age-groupand decreased with increasing age. AML risk increased with theduration of follow-up but there was no change of risk duringthe 23 years of this study. Conclusion: AML risk was elevated after a prior diagnosis ofBC but there was no evidence of an increasing risk of AML aftera BC diagnosis or, in any of the other cancer cohorts, duringthis era of expansion of the evidence base for more intensivetreatments. Key words: acute myeloid leukemia, all cancers, breast cancer, epidemiology, hematological malignancies Received for publication June 18, 2008. Accepted for publication June 23, 2008.     

Distal stent delivery with guideliner catheter: First in man experience

Failure to deliver stents is one of the commonest causes of procedural failure in contemporary PCI practice. We describe successful use of the Guideliner Catheter, the first purpose designed FDA and CE marked device delivery catheter in 13 complex cases in native coronary vessels and bypass grafts performed via the radial route to enable distal stent delivery following failure of conventional techniques. We discuss how the Guideliner catheter may be used to facilitate difficult radial cases. © 2010 Wiley‐Liss, Inc.     

Gastrointestinal teratomas: CT and US appearance with pathologic correlation

Gastrointestinal teratomas are uncommon, benign neoplasms that occur primarily in children. A retrospective review of five cases (two gastric, one pancreatic, one mesenteric, and one in the lesser omentum) is presented with emphasis on the computed tomographic and ultrasonographic appearances. Principal findings are a well-defined mass with separate cystic and solid components of varying proportions, discrete areas with densities similar to that of fat, or coarse, globular calcifications within the solid component. Recognition of these findings may allow the radiologist to make a correct preoperative diagnosis of teratoma.     

Intrauterine spermatic cord torsion in the newborn: sonographic and pathologic correlation

In five newborn patients with spermatic cord torsion, sonography demonstrated an enlarged and globular testis, hydrocele, and skin thickening. In four of these patients the testicular parenchyma was heterogeneous. Peripheral hypoechoic areas were seen in two of the four patients; the other two had a central hypoechoic region and a peripheral echogenic rim. The testis in the fifth patient was diffusely hyperechoic. Duplex Doppler sonography performed in two patients failed to demonstrate any signal in the spermatic cord in either the abnormal or contralateral hemiscrotum. Scintigraphic findings were positive for testicular torsion in two patients and equivocal in three patients. Surgery was performed 2-12 days after sonography and established the diagnosis of spermatic cord torsion. Pathologic examination demonstrated hemorrhagic infarction of the entire testis as well as scattered calcifications. The authors conclude that a solid globular testicular mass seen during the neonatal period is suggestive of intrauterine spermatic cord torsion.